Systematic Review: The Effect of Preventive Lamivudine on Hepatitis B Reactivation during Chemotherapy

Loomba, Rohit; Rowley, Ayana K.; Wesley, Robert; Liang, T. Jake; Hoofnagle, Jay H.; Pucino, Frank; Csákó, György

doi:10.7326/0003-4819-148-7-200804010-00008

Cited by 421 publications

(371 citation statements)

References 33 publications

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“…4 Administering oral anti-HBV agents before chemotherapy is an effective means of reducing HBV reactivation and preventing fatal complications in patients with chronic HBV infection. [12][13][14] The American Association for the Study of Liver Diseases has recommended that all persons at high risk for HBV be screened for prior HBV infection before chemotherapy. 15 The guidelines of the European Association for the Study of the Liver also advise HBV testing before starting chemotherapy.…”

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confidence: 99%

Prevention of acute exacerbation of chronic hepatitis B infection in cancer patients receiving chemotherapy in a hepatitis B virus endemic area

et al. 2015

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Reactivation of hepatitis B viral (HBV) infection in cancer patients undergoing chemotherapy may cause interruption of chemotherapy and lead to liver failure and death. In our institute, a computerized order entry-based alert system was introduced in September 2011 to remind healthcare providers of HBV testing when prescribing chemotherapy. Since August 2012, an order entry-based therapeutic control system has been applied to ensure HBV prophylaxis during chemotherapy. This retrospective cohort study included cancer patients receiving chemotherapy in the Kaohsiung Veterans General Hospital from November 2009 to June 2013. The prechemotherapy HBV screening rate, HBV prophylactic rate, and severe HBV acute exacerbation rate were compared between stages with different order systems. Newly diagnosed cancer patients (n 5 2512) were included. The HBV testing rate in the screening reminder stage was higher than that in the educational stage (93.5% versus 40.2%, P < 0.001), whereas the adequate HBV prophylactic rates in the two order entry-based stages were comparable (41.1% versus 39.2%). Patients in the order entry-based therapeutic control stage had a higher HBV screening rate (99.3% versus 40.2%, P < 0.001) and a higher HBV prophylactic rate (95.8% versus 39.2%, P < 0.001) than those in the educational stage. Additionally, the severe HBV acute exacerbation rate in the therapeutic control stage was lower than those in the educational and screening reminder stages (0% versus 1.2% and 1.2%, respectively; both P < 0.01). Conclusion: A computerized order entry-based therapeutic control system can provide excellent prechemotherapy HBV screening for cancer patients undergoing chemotherapy and can effectively prevent severe acute exacerbation of HBV infection in hospitals among HBV endemic areas. (HEPATOLOGY 2015;62:387-396) 4 The incidence of HBV reactivation in patients with lymphoma and resolved hepatitis B after rituximab-based therapy ranges from 1.5% to 23.8%. [5][6][7][8] Reactivation of HBV infection in cancer patients receiving chemotherapy may cause interruption of chemotherapy and, in severe cases, lead to liver failure and death. 9-11 Additionally, the prognosis of cancer may be compromised by disruption in anticancer treatment Abbreviations: ALT, alanine aminotransferase; anti-HBc, antibody to hepatitis B core antigen; CI, confidence interval; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; HCC, hepatocellular carcinoma.From the

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Prevention of acute exacerbation of chronic hepatitis B infection in cancer patients receiving chemotherapy in a hepatitis B virus endemic area

et al. 2015

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“…A large metaanalysis of role of Lamivudine prophylaxis during chemotherapy included 13 studies enrolling 424 patients who did not receive prophylaxis and found that the overall HBV reactivation rate was 50% (range 24-88%). 34 The type of malignancy as well as the chemotherapeutic agent employed influences the risk of HBV reactivation. As compared to other solid tumors, the highest rates of HBV reactivation have been reported in patients with breast cancer where the incidence ranges between 41 and 56%.…”

Section: Risk Factors Of Hepatitis B Virus Reactivationmentioning

confidence: 99%

Acute Exacerbation of Chronic Hepatitis B: The Dilemma of Differentiation from Acute Viral Hepatitis B

Puri

2013

Journal of Clinical and Experimental Hepatology

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Exacerbations of chronic hepatitis B are common in endemic countries. Acute exacerbation of chronic hepatitis B virus (CHB-AE) causing derangement of liver functions may be seen in a flare of HBV in immune clearance phase or as a reactivation of HBV in patients with inactive or resolved HBV infection. While reactivation of HBV is usually seen in HBsAg positive patients, it is being increasingly recognized in patients with apparently resolved HBV infection who do not have HBsAg in serum but have IgG antibody to core antigen (anti-HBc) in the serum, especially so in patients on chemotherapy, immunosuppressive therapy or undergoing hematopoietic stem cell transplantation. In an icteric patient who is HBsAg positive, it may be difficult to differentiate CHB-AE from acute viral hepatitis B (AVH-B). Both may have similar clinical presentation and even IgM anti-HBc, the traditional diagnostic marker of AVH-B, may also appear at the time of exacerbation of CHB. The differentiation between CHB-AE and AVH-B is important not only for prognostication but also because management strategies are different. Most cases of AVH-B will resolve on their own, HBsAg clearance is achieved spontaneously in 90-95% of adults and treatment is rarely indicated except in the few with severe/fulminant disease. In contrast, in CHB-AE, the onset of jaundice may lead to decompensation of liver disease and treatment is warranted. The mechanisms of acute exacerbation and the differentiating features between AVH-B and CHB-AE are reviewed. ( J CLIN EXP HEPATOL 2013;3:301-312)

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“…One systematic review looked at whether lamivudine reduced hbv reactivation among cancer patients who are hbv surface antigen-positive receiving chemotherapy 84 .…”

Section: Infection Risk With Antineoplastic Agents Questionmentioning

confidence: 99%

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016

Bossé

Ahmad

et al. 2016

Current Oncology

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The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5-7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics:■ Follow-up and survivorship of patients with resected colorectal cancer ■ Indications for liver metastasectomy ■ Treatment of oligometastases by stereotactic body radiation therapy ■ Treatment of borderline resectable and unresectable pancreatic cancer ■ Transarterial chemoembolization in hepatocellular carcinoma ■ Infectious complications of antineoplastic agents

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Systematic Review: The Effect of Preventive Lamivudine on Hepatitis B Reactivation during Chemotherapy

Abstract: Preventive therapy with lamivudine for patients who test positive for HBsAg and are undergoing chemotherapy may reduce the risk for HBV reactivation and HBV-associated morbidity and mortality.

Cited by 421 publications

References 33 publications

Prevention of acute exacerbation of chronic hepatitis B infection in cancer patients receiving chemotherapy in a hepatitis B virus endemic area

Prevention of acute exacerbation of chronic hepatitis B infection in cancer patients receiving chemotherapy in a hepatitis B virus endemic area

Acute Exacerbation of Chronic Hepatitis B: The Dilemma of Differentiation from Acute Viral Hepatitis B

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016

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